Successful treatment of a case of lethal dose of felodipine poisoning with V-A ECMO
10.3760/cma.j.cn114015-20240701-00506
- VernacularTitle:V-A ECMO成功救治致死剂量非洛地平中毒1例
- Author:
Xiangyu ZHU
1
;
Mingyue SUN
;
Yuan LIU
;
Zhikun ZHAO
;
Ping JIANG
;
Weiwei PAN
;
Ziyu WANG
;
Yajuan ZHANG
;
Jing FU
;
Haichen YANG
;
Yeping DU
;
Jinsong ZHANG
;
Yan SHI
Author Information
1. 淮安市第二人民医院急诊与重症医学部，淮安 223002
- Publication Type:Journal Article
- Keywords:
Felodipine;
Poisoning;
Extracorporeal membrane oxygenation
- From:
Adverse Drug Reactions Journal
2025;27(6):369-371
- CountryChina
- Language:Chinese
-
Abstract:
A 36-year-old male developed unconsciousness and no response to voice stimuli after taking approximately 2 050 mg felodipine (the specific time was unknown). Two hours later, he was sent to the department of emergency by his family and admitted to the hospital. His vital signs showed body temperature 35.1 ℃, pulse 148 times/min, respiration 32 times/min, and blood pressure 65/34 mmHg. Acute drug poisoning, acute toxic cardiomyopathy, acute toxic shock, acute type Ⅱ respiratory failure, acute toxic encephalopathy, and acute renal failure were diagnosed based on the patient′s clinical manifestations combined with laboratory tests results, cardiac ultrasound, chest and abdominal CT scans. Endotracheal intubation connected to a ventilator for invasive assisted ventilation, pressure boosting, and fluid resuscitation were given. At the same time, repeated gastric lavage and enema were performed to remove toxins. Blood perfusion was intermittently and repeatedly administered, and continuous renal replacement therapy was used. The blood concentration of felodipine was 1 298 μg/L at 2 hours after admission, and cardiac arrest occurred at 4 hours. Venous-arterial extracorporeal membrane oxygenation (V-A ECMO) treatment was administered immediately. After 48 hours of ECMO operation, sedatives were discontinued and the patient′s consciousness was improved after 4 hours. On the 5th day of ECMO treatment, his heart rate was 72 beats per minute, and blood pressure was 127/65 mmHg. The blood concentration of felodipine decreased to 2 μg/L. The patient′s vital signs were significantly improved and ECMO supportive treatment was withdrawn. After 26 days of hospitalization, the patient recovered and was discharged.
